April 14, 2025 - Attorney General Miyares Joins Bipartisan Coalition Asking Congress to Prohibit PBMs from Owning or Operating Pharmacies

Attorney General Miyares Joins Bipartisan Coalition Asking Congress to Prohibit PBMs from Owning or Operating Pharmacies 

RICHMOND, VA — Attorney General Jason Miyares today joined 38 other attorneys general in sending a letter to congressional leadership urging them to pass an act that would prohibit pharmacy benefit managers (PBMs) from owning or operating pharmacies.

“PBMs were originally created to streamline prescription drug access and reduce costs for patients, but they’ve become powerful gatekeepers, operating without transparency or accountability. When the same companies that negotiate drug prices also own the pharmacies dispensing those drugs, it creates a clear conflict of interest—one that exploits consumers and jeopardizes independent pharmacies,” said Attorney General Jason Miyares. “It’s time for Congress to help restore balance to the prescription drug marketplace. Virginians, and Americans, deserve better, and I’m fighting to ensure they get it.”

PBMs are third-party administrators of prescription drug programs for health plans. Over the past few decades, horizontal consolidation and vertical integration have transformed PBMs from useful administrative service providers into market-dominating behemoths that control the industry. Each of the top six PBMs operate their own affiliated pharmacies, while five of the top six are also a part of parent conglomerates that operate insurance companies and health care clinics. PBMs—through ownership of affiliated pharmacies—are contracting with and have power over their own pharmacies’ competition. The PBMs then use their place as middlemen to exert this power in ways that harm independent pharmacies, forcing these small businesses to accept contractual terms that are confusing, unfair, arbitrary, and harmful.

PBMs have been largely unregulated for decades. In the absence of federal regulation, States like Virginia have stepped up to protect consumers and pharmacies, but have continued to face challenges from the PBM industry. In 2024, 39 attorneys general, including Attorney General Miyares, urged Congress to take further actions to regulate PBMs at the federal level. 

The letter sent today urges Congress to take action and protect consumers by enacting a law prohibiting PBMs or their parent companies from owning a pharmacy.

In addition to Virginia Attorney General Miyares, the attorneys general of the following states and territories also signed on to the letter: Alaska, American Samoa, Arizona, Arkansas, California, Delaware, District of Columbia, Hawaii, Illinois, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, North Dakota, Ohio, Oregon, Pennsylvania, Rhode Island, South Dakota, Tennessee, Utah, Vermont, Virgin Islands, Washington, West Virginia, Wisconsin, and Wyoming.

To read the letter, click here.

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